No abstract available.
Larynx, Artificial* ; Voice*

Aged ; Humans ; Laryngectomy ; instrumentation ; Larynx, Artificial ; Male ; Middle Aged

Percutaneous dilatational tracheostomy (PDT) is a widely used method to perform tracheostomy in the critical care medicine for patients who need prolonged mechanical ventilation. Traditionally, PDT has been facilitated by bronchoscopy via the endotracheal tube. However, there are risks for blocking the view of correct puncture site on the trachea or being extubated unintentionally, which lead to loss of the airway. These complications are possibly due to insufficient bronchoscopic visualizations via endotracheal tube during the procedure. Using laryngeal mask airways (LMA) during PDT may overcome these problems and could provide a safer alternative method with superior visualizations of the trachea and larynx. We report a case of percutaneous tracheostomy being performed successfully under bronchoscopy with LMA in the intensive care unit.
Bronchoscopy ; Critical Care ; Humans ; Intensive Care Units ; Laryngeal Masks ; Larynx ; Punctures ; Respiration, Artificial ; Trachea ; Tracheostomy ; Triazenes

Humans ; Esophagus ; Manometry ; Botulinum Toxins/therapeutic use* ; Prostheses and Implants ; Treatment Outcome ; Larynx, Artificial

OBJECTIVE: To analyze the clinical characters, surgical treatments and prognosis of differentiated thyroid carcinoma (DTC) with laryngeal or tracheal invasion. METHOD: Forty-six cases including 33 papillary and 13 follicular were retrospectively reviewed. Thirty-four cases with tracheal invasion received conservative resection (17), window resection (11) and sleeve resection (6). One case with subglottic invasion was performed subglottic partial laryngectomy. Eleven cases with trachea-laryngeal invasion received total laryngectomy(4), 3 shave technique and 4 preservative laryngectomy. RESULT Complications included infections and hypocalcaemia, 15 patients got permanent fistula. 5-year survival rate in cases of tracheal shave resection was 88.2%, while 63.6% in those of window resection and 83.3% in those of sleeve resection. Survival rate within 5 years of patients received preservative laryngectomy was 62. 5%. Conclusion: With meticulous preoperative examination and positive surgical treatment, both survival rate and quality of life could be improved in patients of DTC with laryngeal or tracheal invasion.
Adenocarcinoma ; Humans ; Laryngectomy ; Larynx ; pathology ; Larynx, Artificial ; Neoplasm Invasiveness ; Prognosis ; Quality of Life ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; pathology ; surgery ; Trachea ; pathology

OBJECTIVETo evaluate the extensive and degree of physical rehabilitation improvement of the quality of life in laryngectomees.

METHODSForty nine patients who underwent total laryngectomies were trained by esophageal voice rehabilitation successfully. The questionnaires of performance status scale for head and neck cancer patients (PSS-HN) and the functional assessment of head and neck cancer therapy (FACT-H&N) were answered by them before esophageal voice training and 3 months after successful vocal rehabilitation.

RESULTSTotal laryngectomy deteriorated the quality of life in laryngectomees. The mean scores of PSS-HN scale and FACT-H&N questionnaire were lower than the criteria scores after patients underwent total laryngectomy, the mean score were 131. 4,90.6 respectively, the difference was significant statistically (t =53. 673, P <0.001) , (t = 67.44, P <0.001). After successful esophageal speech training, the mean scores of the laryngectomees were improved both in PSS-HN scale and FACT-H&N which were 240.4 and 103.7 respectively, the difference was significant statistically (t = 18.209, P < 0.001) , (t = 21.389, P<0.001).

CONCLUSIONSThe quality of life in laryngectomees can be improved by physical rehabilitation and the esophageal voice training.

Adult ; Aged ; Female ; Humans ; Laryngectomy ; rehabilitation ; Larynx, Artificial ; Male ; Middle Aged ; Quality of Life ; Speech, Esophageal ; Surveys and Questionnaires ; Voice Training

The main problem after total laryngectomy is permanent loss of voice. Current methods of vocal rehabilitation after total laryngectomy include development of esophageal speech, use of artificial larynx, tracheoesophageal shunt operations and more recently surgical restoration of the voice with prosthesis. Primary voice restoration using Blom- Singer voice prosthesis after total laryngectomy and pharyngeal myotomy was performed in 187 patients between October 1992 and July 2000. There were 184 male and 3 female patients of average age 63.7 years (range 42-76). Mean follow up period was 62 months. Satisfactory speech was achieved in 156 patients (83.5%). During the follow-up period, we experienced complaints of insufficient voice in 31 (16.5%) patients, due to partial spasm in 17 and total spasm in the pharyngoesophageal segment in 14. Furthermore, 24 (12.8%) patients preferred esophageal speech or electro larynx because of low socioeconomic level. The overall success rate was 70.7%. In this study the results of the surgical technique and prosthesis insertion, as well as the associated complications and socioeconomic levels of the patients, are discussed.
Adult ; Aged ; Carcinoma, Squamous Cell/surgery ; Female ; Human ; Laryngeal Neoplasms/surgery ; Laryngectomy/*adverse effects ; *Larynx, Artificial/adverse effects ; Male ; Middle Aged ; Pharyngeal Muscles/surgery ; Voice Disorders/etiology/*surgery

OBJECTIVETo study the aerodynamic characteristics of low-resistance Groningen voice prosthesis for total laryngectomees and the related clinical significance.

METHODSThree aerodynamic parameters were measured in 24 laryngectomees implanted with low-resistance Groningen voice prosthesis: the sound pressure level (SPL), intratracheal pressure (pressure) and airflow rate (flowrate). Among them, 6 cases were initially implanted with other prosthesis which was replaced by the Groningen buttons later. The parameters were measured for both old and new prosthesis. The relationship between the variables were computed with means of Pearson' s product-moment correlations.

RESULTSThe parameters were measured repeatedly among all cases, 180 group data were collected. Screening test showed that the median of sound pressure level, intratracheal pressure and airflow rate are respectively 88.0 dB, 73.6 cm H2O (1 cm H2O = 0.098 kPa) and 123.2 ml/s. Thirty times measurement of patients phonation showed that the correlation between SPL and pressure was not significant (r = -0.058, P > 0.05). The relationship between flow rate and SPL was not significant(r = -0.119, P > 0.05). The correlation between pressure and flow rate was significant(r = 0.699, P < 0.05). CONCLUSIONS When pseudoglottis vibration is produced by sub pseudoglottis air flow, pseudoglottis vibration and voice loudness can not be increased by continuous air flow.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kinetics ; Laryngeal Neoplasms ; rehabilitation ; surgery ; Laryngectomy ; rehabilitation ; Larynx, Artificial ; Male ; Middle Aged ; Prosthesis Design ; Speech Articulation Tests ; Speech, Alaryngeal

INTRODUCTIONThis study aimed to assess the factors that influence the longevity and replacement frequency of Provox voice prostheses following their placement.

METHODSThe medical records of 27 patients who received Provox voice prostheses after total laryngectomy and attended follow-up regularly between 1998 and 2012 were retrospectively reviewed. The success rate of the Provox voice prostheses (i.e. whether speech was achieved), quality of speech achieved, number and type of complications encountered, frequency of prostheses replacement and reasons for prostheses replacements were evaluated.

RESULTSAll 27 patients were men and their mean age was 63.0 (range 43-78) years. The mean follow-up period was 60.3 (range 1-168) months. Fluent and understandable speech was achieved in 85.0% of the patients. The mean duration before prosthesis replacement had to be performed was 17.1 (range 1-36) months. The most frequent complication was fluid leakage through the prosthesis. There was a strong positive correlation of 77.1% between the longevity of prostheses and postoperative follow-up duration (r = 0.771; p < 0.01).

CONCLUSIONThe voice prosthesis is a tool that can be delivered in a practical fashion and replaced easily with no serious complications. It is a means by which speech can be restored, with a high success rate, after total laryngectomy. In the present study, we found that postoperative follow-up duration was the most important factor influencing the longevity of the Provox voice prosthesis.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Laryngeal Diseases ; surgery ; Laryngectomy ; Larynx, Artificial ; Longevity ; physiology ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Prosthesis Design ; Reoperation ; Retrospective Studies ; Time Factors

OBJECTIVE: To discuss the effect of reducing the cricopharyngeal dysfunction on the Groningen prosthesis voice restoration following total laryngectomy and the effect of different methods. METHOD: Fifty-six patients were implanted with Groningen voice prostheses to rebuild voice after total laryngectomy. The clinical data were analyzed retrospectively. RESULT: Of 56 patients, 412 patients successes in voice restoration. The success rate of amputating pharynx plexus nerves group was 60.0%, amputating cricopharyngeal muscle group was 62.5%, and the amputating pharynx plexus nerves and cricopharyngeal muscle group was 96.0%. CONCLUSION The combination of pharynx plexus nerves resection and cricopharyngeal myotomy can make higher success rate of voice restoration.
Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Larynx, Artificial ; Male ; Middle Aged ; Pharyngeal Muscles ; physiopathology ; Retrospective Studies